| NPI | 1417017104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX h9446) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TX H9446) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2008-12-16 |